Every day Covid cases are fronting up to Middlemore, but so far despite handling more than 80 Delta cases during the outbreak, not a single patient or staff member has caught the virus in an exposure event.
Counties Manukau DHB chief medical officer Dr Pete Watson told Q+A that the hospital has improved quickly at screening people.
"When they front up to the emergency department we ensure that we take a really close history and checklist of potential infections."
Those that appear at risk are separated into a "Covid stream" early on, where all staff are in full PPE and nearly all staff are fully vaccinated.
However they are still "really cautious" with everyone, "testing the majority of people who come into the ED" and that the "focus is on finding every potential case that’s walking into the the hospital".
Middlemore has dealt with roughly a third of the country’s Covid cases outside of MIQ.
Watson told presenter Jack Tame that they are constantly reviewing and updating procedures as new information comes to hand.
That includes trialing new technology such as rapid antigen tests. Middlemore is doing 60 to 80 tests a day.
Watson says the rapid antigen tests have detected Covid cases which are then confirmed by PCR tests, however they have also had people who have had negative results from antigen tests, so they will continue doing them side by side.
"PCR remains the test of choice for the diagnosis of Covid."
He says that staff at the hospital, and throughout the medical community, are concerned about what the future looks like.
"We knew when we came in to Covid that the health system was short — short of nurses, short of particular types of other clinicians like anesthetists ..."
"The biggest thing here is ... trying to reduce the peak and the surge that’s coming and the way to do that is through vaccination and a range of public health controls."